the public health service. its people and programs affect the lives of millions of americans every day. whether it is a matter of medical research, food and drugs, contagious diseases, or the delivery of health care, the public health service plays a significant role. how the public health service became what it is today is really the story of public health in america, a story that is still unfolding.

♪ ♪ throughout the years, the public health service has fought its battle in plague ridden cities and the corridors of power in washington. today's public health service agencies are challenged by an ever changing world and they respond. the centers for disease control and prevention strive to protect citizens from infectious and non infectious diseases. the health resources and services administration supports the training of health professionals and sends them to underserved areas. the national institutes of health conduct basic research on diseases such as aids. the food and drug administration hastens the approval process to bring new drugs to the public. the substance abuse and mental health services administration provides services for mental,

behavioural and addictive disorders. the health related concerns connected with hazardous wastes are increasingly important, and are the responsibility of the agency for toxic substances and disease registry. a relatively new addition to the ph as is the ad agency for health care policy and research. the agencies drives to assess the effectiveness of medical care. the public health service also response to needy members of the community, providing care to native americans through its indian up service. it also assists the elderly, drug addicts, those with aids and others who might be forgotten. when it started, its mission then as well was to serve a group that had little access to medical care, merchant seamen. that was in 1798, when an act of congress signed into law by president john adams, provided for the government to maintain

hospitals for sick or disabled semen, as had traditionally been done in england. for its first 80 years or so, what was then known as the marine hospital fund was administered by custom inspectors in the sea ports of the nation. as the united states grew, so did the number of ports. , hospitals and clinics sprouted on the east coast as well as the west coast and up the mississippi. by 1870, the system needed to be revamped. the reorganization led to the appointment of the first surgeon general, john maynard woodworth. he had been a army medical officer in the civil war. woodworth put his officers in uniform, created a flag and

instituted the military system appointment by merit. doctor woodworth's reforms were formalized by law in 1889, when the commission corps of the u.s. marine hospital service was created. as the commission corps was expanding during the closing years of the 19th century, so was biological discovery. the scientific ferment brought changes to the marine hospital service. it's hygienics laboratory, started in 1887, was a pioneer in biomedical research. it manufactured biological's and trained scientists from state health departments in the techniques of producing them. years later, it became the national institute of health, the heart of american medical research. boarding vessels at u.s. ports to check passengers and crews

for infectious diseases was also the responsibility. this task had originally been handled by the states. but as immigration mushroom, the responsibility was transferred to the federal government. at all ports of entry, the marine hospital service was in charge of inspection of arriving immigrants, including the most important of them of all, ellis island. the service pioneered the line. it was inefficient way to check for immigrants with disease, blindness and mental deficiencies. anyone who might become a public charge. more than 12 million immigrants, as many as 5000 a day at times, passed through ellis island under the examining hands and watchful eyes of the marine hospital service. in 1900 to, the service was renamed. it became the public health and marine hospital service. in 1912, as legislation increased its scope of activities, its name was

simplified to the public health service. in the early 1900s, the service lead the fight in investigating dozens of diseases and developing treatments for them. a service battle -- a serious eye disease that can cause blindness. commission court dr. john mullin took his team to the rural hills of kentucky. he established a hospital and 11 field clinics. he and his team taught personal hygiene to local residents to stem the inflammation. within ten years, the incidents of trachoma cases was greatly reduced. sent them to the montana valley to spot fever. the disease was carried by takes on livestock and other animals. a phs doctor was sent to

montana to control the disease. as he searched for a cure, he became infected with the disease and died. doctor m'clintic was one of five officers to die from rocky mountain spotted fever. a vaccine was ultimately developed to combat the disease. one of the most perplexing diseases of the time was pellagra. 5000 people a year died of it in the early century. this disease was studied. most doctors believed the disease resulted from infection. convinced of his own theories, he and his wife had themselves injected with the blood of those who had the disease. his findings were startling. we report diet, not infection, caused pellagra. soon, pellagra was conquered by

inexpensive dietary supplements. the court pioneered treatment of tuberculosis and bubonic plague control at the risk of their own safety. officers fought their battles in the laboratories and communities as well. in san francisco and other cities, the officers were to vanish the culprits of bubonic plague, rats and ground squirrels and their fleece. energetic cleanup campaigns over the years led to the control of the dreaded played. them venereal disease particularly at the time of world war i was a major concern. a service developed tests and public education campaigns and ran research centers like this one in arkansas. workers took on child health as a responsibility as well. we phs personnel traveled throughout the countryside of america, examining and

inoculating youngsters against diseases such as typhoid. then there was the matter of keeping vital statistics. early work in bridal statistics kept staffers busy. this was the personal come pewter of the twenties. it compilation and interpretation relating to health and disease involved the phs then as now. at the center of the work in the twenties and thirties was disease control and sanitation in rural communities. they were preoccupied with previous. there were the good ones, the bad ones and the worst ones. along with evaluating previous, the service designed, built and distributed toilets. the bottom line was good outhouses like this one. during those years, the service

successfully battled with dozens of infectious diseases including malaria, typhus, yellow fever and hookworms. during the twenties and thirties, the marine hospitals remained the core of the public health service. the hospitals employed the majority of phs personnel and served as a training ground for physicians. dentists and other clinicians. as the thirties war on and the nation struggled its way out of the depression, the public health service became part of the cure. the social security act of 1935 was landmark legislation, providing the dhs with the authority to make grants to help develop and improve state and local health departments. we >> one of the most significant advance in public health ... >> the surgeon general at the time was an ardent publicist for the health causes of the day. he made syphilis prevention one of the main stays of his

mission. his outspoken is on the subject lead to more public attention to venereal disease and its prevention. his conservative british assessor had served four terms in the position and generally opposed phs assistance in local health matters. in 1936, president franklin d. roosevelt believe him as surgeon general and appointed the longtime public health officer. the essence of fdr's new deal resonated with parents considerably broader view of public health. during the roosevelt administration, 55 acres in rural maryland became the new home of what had originally been the hygienics laboratory. with >> the national institute of health speaks the universal language of humanitarianism. >> in 1930, the laboratory's

name have been changed to the national institute of health. we moved a bit as the prepared the nih for its period of rapid growth in the post war years. and teen 41 saw the country's entry into world war ii. public health service officers served in several different ranks of the armed forces. many were assigned to the coast guard ended everything from making sea borne house calls while on convoy patrol to supporting amphibious landings. perhaps one of the most fundamental changes brought about by the war was in nursing. the strain of war on the country's health care system made it clear that something had to be done to increase the supply of nurses. the answer was the cadet nurse court, which was formed to meet the need. and women enrolled in nursing schools and received a full education. they were paid a salary by the dhs and we're obligated to perform military or federal

service in return for their education. 85% of the nurses graduated in the years 1943 through 46 were in the nurse corps. the quality of nursing education was changed forever. as a result of policy and funding, nursing schools were no longer in the shadow of hospitals, which had previously been there so sponsors. it was a tremendous boost to the profession. the epa chess's most important legacy was the atlanta-based malaria control program, often referred to as the ncaa. larry control was a major activity in the american south and caribbean during the war. at the end of the war, it became clear that the mcwa had developed an important role in infectious disease research and control. so it was continued, providing

practical applications of public health research techniques to problems such as typhus control. the agency remained at its atlanta base and was renamed the communicable disease center. later, as we know it today, it became the centers for disease control and prevention. the cdc handles everything from highly toxic viruses to quarantine expertise for the space program. along with a valuable work of the cdc, dhs makes major contributions to the nation's health. in the 1940s, 95% of the population suffered from tooth decay. but in some parts of the country, people had low levels of decay. their teeth were modeled and pitted. ph as researchers in the field and labs with the prime detectives and solving the case. and i extent is to term and

that teeth were modeled because of elevated levels of fluoride in drinking water, and that fluoride led to a reduction in tooth decay. in 1945, grand rapids michigan was the first city to test this proposition. at 4 pm on january 25th 1945, grand rapids began adding fluoride to its water supply. school children actively participated. the results were astounding. fluoride in the water reduced dental decay by as much as 60%. fluoridation became the principal public health strategy in the prevention of tooth decay. since the early 1900s, dental in medical care for native americans have been provided by phs personnel on loan to the indian field service. but in 1954, an act of congress transferred formal responsibility for the health of american indians to the public health service. it was the hope that a program

administered by health professionals could improve the health of indians. that proved to be the case. by 1960, native american infant mortality had declined by almost 25%, and the death rate from tuberculosis by almost 50%. today, that program is an agency of the phs, the indian health service. public health physicians also served in need of another, often forgotten, sector of the population, prison inmates. since 1930, phs officers have worked with the bureau of prisons, it's facilities, and hospitals. environmental health issues surfaced in the forties in steel towns like can or, up pennsylvania. smog made 600 people ill and killed another hundred 20. along with air pollution, concerns about water pollution we're mounting as well.

radiation in the atmosphere from nuclear testing was apparent. the phs began to study radiation and its biological effects. environmental health concerns have stayed on the scene, growing in prominence. within the cdc, public health teams deal with toxic substances. since the seventies, the national institute for occupational safety and health has dealt with a myriad of industrial and environmental issues. postwar development in biomedical research paid rich dividends and lead to nobel prize honors for dozens of investigators supported by nih grants. for scientists from the nih have been nobel laureates. marshall nuremburg for breaking the genetic code, julius axelrod for his work on the central nervous system, christian won a chemistry prize for work on a media acids, and

carleton isolated a virus fatal among natives of new guinea. as reflected in his work, international health has become an area of importance for the ph, fs1 with notable exceptions. the cdc, for instance, provided leadership for the global camp and it resulted in the conquest of smallpox. in 1967, surgeon general william stewart had pledged ph as personal to the world health organization campaign against smallpox. more than 300 physicians, scientists, and public health workers led by the cdc's doctor d. a henderson went all of the globe to fight the battle. and they won. by 1977, smallpox had been eradicated throughout the world. in the 1960s, reorganization brought new programs to the phs fold. one of the most significant was the food and drug

administration, which had been an independent agency sends its exception. its original responsibility was for the protection of the american consumer against adulterated or mislabeled food and drugs. today, the agency set standards in the areas of food, drugs, cosmetic, radiation, health, and medical devices. the agency has labored to expedite and improve the approval process for new drugs. reorganization in the early 1970s established the phs and it's essential form of today. one of those changes was bringing programs for mental land addictive disorders together into one agency. today, the substance abuse and mental health services administration administers prevention and treatment programs in these areas, while research activities and mental health and substance abuse are

carried out by the national institutes of health. during the 19 seventies, the phs became heavily involved in the delivery of health services to poor, isolated populations. a community health center program supported more than 800 health centers throughout the country, and provide medical care workers to these communities through the national health service corps. these programs remain a vital part of the public health service today, as the needs of the medically underserved continue to grow. the health resources and services administration supports both state and community efforts to serve those who are less fortunate, and provides health care practitioners to staff of those systems. the organization continues to support the education of health professionals through scholarships and training programs. to assure the quality and effectiveness of health services, the agency for health

care policy and research has been established. it sponsors health services and medical outcomes research toward the goals of improving the practice, organization, financing, and delivery of health care services. the phs has led the national and global battle against hiv and a.i.d.s., carrying out primary research on the virus and sponsoring prevention and treatment programs throughout the country. all of the agencies are engaged in this monumental public health campaign. the public health service is made up of both civil servants and commission core members. in addition to staffing the agencies of the phs, the commission corps provides clinical unscientific personal for the bureau of prisons, the coast guard, the environmental protection agency, and the national oceanographic administration. in the 19 eighties, surgeon

general see ever coop captured the public, i bringing visibility to health issues with his outspoken reports on aids and smoking. today, the public health service is part of the department of health and human services, and the heads of its agencies, now called operating divisions, report to the secretary of health and human services. the assistant secretary for health and the surgeon general advised the secretary on health policy and programs. the operating divisions of the public health service provide political care while protecting the consumer through regulation of food, drug, and medical devices. the service also continues to conduct biomedical and behavioural and health research care throughout the united states and much of the world. the phs maintains its tradition of public health campaigning with its healthy people programs to promote health

awareness and public action throughout the united states. and the service continues its scientific and public education battle against the epidemic of disease caused by tobacco. with a wealth of achievements, and a proud history, the public health service protects and advances the health of the american people. it does so with its special blend of science and government, tradition and public service and personal commitment. it's work continues to respond to the ever-changing mandates of science, the dictates of government, and the needs of the people.

this videotape is based on the book plagues and politics, the story of the united states public health service written by doctor fits who mullin.

up next, for the study of slavery resistance and abolition at the mcmillon center of yale university. historian, manuel barcia, discusses his book, the yellow diamond fever, fighting disease in the 19th century transatlantic slave trade. >> i did not plan for this book to come out in the middle of a pandemic first of all. i promise, i don't have a crystal ball. >> timing is everything. >> i know. but it has been tough having to talk about the disease. on a more personal layer, these experiences of the subject of my book. trying to find out what is going on.